				<div class="form-group" {guanlians}>
					<label class="col-xs-12 col-sm-3 col-md-2 right-label">{{check_show_lang('{title}')}}</label>
					<div class="col-xs-12 col-sm-8 col-lg-9">
						<div class="row row-fix tpl-district-container">
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select ng-model="{tovalue}.{name}.year" class="form-control tpl-province">
								<option value="" selected="selected">年</option>
								<option ng-repeat="value in pagedata.years" value="{{value}}" ng-selected="{tovalue}.{name}.year==value">{{value}}</option>
								</select>
							</div>
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select ng-model="{tovalue}.{name}.month" class="form-control tpl-city">
								<option value="" selected="selected">月</option>
								<option ng-repeat="value in pagedata.months" value="{{value}}" ng-selected="{tovalue}.{name}.month==value">{{value}}</option>
								</select>
							</div>
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select ng-model="{tovalue}.{name}.day" class="form-control tpl-district">
								<option value="" selected="selected">日</option>
								<option ng-repeat="value in pagedata.days" ng-show="showday({tovalue}.{name}.year,{tovalue}.{name}.month,value)" value="{{value}}" ng-selected="{tovalue}.{name}.day==value">{{value}}</option>
								</select>
							</div>
						</div>
						<div class="help-block">{help}</div>
					</div>
				</div>
